锁定钢板固定股骨转子下Seinsheimer Ⅴ型骨折

Locking plate for internal fixation of Seinsheimer type Ⅴ femoral subtrochanteric fractures

[目的]探讨锁定钢板治疗股骨转子下Seinsheimer V型骨折的疗效。[方法]2014年9月-2019年1月采用锁定钢板固定治疗股骨转子下Seinsheimer V型骨折共计16例,记录患者围手术期情况及随访结果。[结果]16例患者均顺利完成手术,手术切口长度(12.50±1.45)cm,手术时间(133.75±18.21)min,术中出血量(493.75±83.42)ml,术后1例出现切口月旨肪液化。术后随访时间(22.52±5.04)个月,骨折临床愈合时间为(7.88±1.15)个月。末次随访VAS为(0.50±0.63)分,髋关节伸屈ROM(135.88±6.30)°,髋关节Harris评分(88.19±6.28)分。临床结果评定为优10例,良5例,可1例,优良率93.75%。[结论]股骨转子下Seinsheimer V型骨折复位困难,锁定钢板内固定术是一种安全有效的手术方式,骨折愈合及临床疗效良好。

[Objective]To explore the clinical outcomes of locking plate for internal fixation of Seinsheimer type V femoral subtrochanteric fractures.[Methods]From September 2014 to January 2019,16 patients underwent open reduction and internal fixation with locking plate for Seinsheimer type V femoral subtrochanteric fractures.The perioperative status and follow-up results of the patients were recorded.[Results]All the 16 patients had operation performed successfully with incision length of(12.50±1.45)cm,operation time of(133.75±18.21)min,and blood loss intraoperatively of(493.75±83.42)ml,whereas a patient got incision fat liquefaction after operation.The postop-erative follow-up period lasted for(22.52±5.04)months on average,while clinical fracture healing achieved in(7.88±1.15)months on aver-age.At the latest follow-up,the patients had VAS score of(0.50±0.63),hip extension-flexion range of motion(ROM)of(135.88±6.30)0,and Harris score of(88.19±6.28)on average.The clinical outcome was marked as excellent in 10 cases,good in 5 cases,fair in 1 case,with an excellent and good rate of 93.75%.[Conclusion]The Seinsheimer type V femoral subtrochanteric fractures is difficult for reduction and fixation,however,locking plating is a safe and effective surgical method with good fracture healings and satisfactory clinical results.